About Goiters
A goiter occurs when the thyroid gland in the neck becomes swollen and enlarged, usually due to the effects of an underlying condition. Goiters used to be commonly associated with a lack of iodine in the diet but the advent of iodized salt in the United States has made that cause very rare. Goiters can get in the way of swallowing and breathing in some cases but are generally not uncomfortable. Goiters can be treated, with the treatment depending on variables such as the size of the thyroid and what is causing the problem to begin with.
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Function
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The normal thyroid gland, located at the base of the neck and weighing less than one ounce, has the job of producing two vital hormones: thyroxine and riiodothyronine. The function of these substances includes maintaining the metabolic rate of a person, keeping the body's temperature under control, regulating the making of certain important proteins, and they also affect the heart rate. Other glands such as the pituitary and hypothalamus join in this process and together with the thyroid gland they have the job of producing and distributing the correct amounts of hormones. But in cases of goiter the thyroid gland can have high or low levels of these hormones, which eventually cause the gland to enlarge for different reasons.
Types
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Before iodized salt became a staple of dinner tables, the lack of iodine in the thyroid was the number one reason for goiters to form. This deficit of iodine makes the thyroid unable to manufacture enough of the hormones and it becomes enlarged when it is stimulated by the pituitary gland repeatedly. This cause of a goiter is still seen in under-developed nations. Graves' disease is now the most widespread reason for goiters, a condition which forces the thyroid to produce too much of the hormones with an enlarged gland as the result. Hashimoto's disease leads to what is called an underactive thyroid, brought about by a disorder which inflames the area and limits the thyroid's ability to make hormones. In multinodular goiter many nodules grow on the sides of the thyroid gland and make it swell up. When only one nodule develops the condition is called solitary thyroid nodule disease. Thyroid cancer can also damage the gland, with the swelling associated with goiter as a side effect.
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Effects
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The symptoms of goiter include the classic swollen neck, sometimes to the point where it is unsightly and easily noticed. This can create tightness in the throat and sometimes will make it hard to swallow, breathe, and even talk if the goiter is pressing on the nerves to the voice box. A patient with goiter will also be prone to bouts of coughing.
Identification
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Swelling in the neck in the region of the thyroid will make a physician suspect goiter. To identify the cause of the swelling blood tests can be administered that can evaluate hormone levels. There are also blood tests that can check for antibodies in the bloodstream that may indicate goiter is the culprit. Ultrasonography can be utilized, a process involving sound waves that will form an image on a screen for viewing, allowing the doctor to see the size of the thyroid gland. A radioactive isotope can be injected into your body during a thyroid scan, which will show a physician how the gland is working and if it has become enlarged.
Prevention/Solution
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When a goiter is relatively small it will be carefully observed until it either shrinks to normal size or becomes more of a problem. There are medications available to treat the ailment, with a focus on increasing or decreasing hormone levels depending on what is occurring in the thyroid. Surgery to remove the entire thyroid or just a portion is an option when a goiter becomes too large and medication isn't working. Radioactive iodine, which will wind up eventually in the thyroid gland after it is ingested orally, can destroy cells in the thyroid and reduce hormone production. However, in some instances the patient will need hormone supplements for the rest of their lives.
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